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Diagnosed with Narcolepsy, had migraines, was on sleeping pills and topamax, been off them. Is that the cause?

HI, My daughter is diagnosed with Narcolepsy but, I do not think that this is her problem. In late 2008 early 2009 she was diagnosed with migraines and she had trouble sleeping at night. The nerologist at that time put her on a sleeping pill . Insurance changed and new nerologist took her off sleeping pill and put her on Topamax for migraines. Insurance changed on us and again so new nerologist who in 2010 did a sleep study and said because she fell into REM sleep in a minute or less when timed she had narcolepsy and put her on Provigil. My issue is that my daughter has been off of her meds since Sept.2012 due to insurance not wanting to pay. She has no issues staying awake throughout the day during school even in her welding classes and no complaints from her teachers. She is in bed by 930 1000 every night and up at 630 in the morning. She has no other signs or symptoms of narcolepsy. What else could be going on with her?
Asked On : Thu, 17 Jan 2013
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Neurologist 's  Response
First of all let me tell you that a given medical problem can be due to various cause and the basic objective of the attending doctor is to establish the cause and treat accordingly. Back to your problem, your daughter has two problems probably, one is migraines and the other could be narcolepsy as per your doctor. Headache can be due to various cause like brain infection, tumor, migrains, problems in the blood vessel in the brain etc. If these causes are excluded than the possibility of primary headache syndrome is entertained. Migrain can be treated with topiramate, valproate (not a good option in girls), propranolol, amitriptiline etc. Coming back to the second part, only sudden onset and short latency to REM sleep may not suggest narcolepsy.These can be modified by medicines too. You have not mentioned the sleep medicines that she is using. You can observe if she is completely asymptomatic as of now.
Hope this clarifies
Answered: Fri, 18 Jan 2013
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